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Improving Corridor Compliance Through
Inventory Analytics
Session 173, February 13, 2019
Jillian S. Waller, M.H.A., Health Systems Engineer,
Management Engineering & Internal Consulting, Mayo Clinic
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Jillian S. Waller, M.H.A. has no real or apparent conflicts
of interest to report.
Conflict of Interest
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Background & Project Goal
Methodology
Findings
Recommendations
Implementation
Post-Implementation
Items for Further Study
Lessons Learned
Q&A
Agenda
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Discuss the challenges of eliminating corridor clutter in space-
constrained facilities
Demonstrate how equipment demand can be measured and
analyzed using basic statistical methods
Describe how a sustainable offsite inventory strategy can be
developed in a manner that works for all stakeholders
Identify the role that institutional norms and individual behaviors
play in managing equipment inventory in a sustainable way, with
emphasis on change management
Learning Objectives
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Hospital hallways cluttered with unused patient care equipment
(e.g. beds, IV poles, recliners, cots)
Eye sore
Potential hazards
Potential accreditation compliance issues
“Aisles, corridors, and ramps required for exit access in a
hospital… shall not be less than 8 feet in clear and
unobstructed width.” (Joint Commission Comprehensive
Accreditation Manuals, Life Safety Code)
Background
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Implications for staff
Motion waste
Difficulty locating items
Implications for equipment itself
Damage, loss, contamination
Space constraints
Available space is valuable
Storage is dead space
Carrying / holding costs
Background
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Identify a storage solution to eliminate hallway clutter.
Goal
Do not use additional space on the downtown campuses.
Use the Methodist Campus as a test case.
Parameters
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Understanding demand for equipment
Analysis of equipment transport request data
Looked at 12 months of historical data
5,961 delivery requests
Significant data prep required
Free-text fields
Methodology
“Can you please
send an ortho bed
to EI_05_04?
Thanks much!!
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Understanding demand for equipment
Analysis of equipment transport request data
Count of requests by date
Mean number of requests per day
Mean request completion duration
Methodology
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Understanding the system
Stakeholder interviews
Nursing
Environmental Services
Direct observation
Inventory
Methodology
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Pareto principle
The five most requested items accounted for 80% of all
delivery requests that year
Cots, beds, recliners, bed extenders, tray tables
On average, requests were completed in 2 hr 10 min
Using 2000 square feet of onsite storage space
Not including what we see in hallways and elevator banks!
Findings
Total Number of Items Requested
Average Request Completion Duration by Item
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Much of the equipment demand could be predicted
Scheduled cases (e.g. ortho, gyn surgery, transplant,
plastics, urology, colorectal surgery, etc.)
Stockpiling or “hoarding” of equipment on floors largely due to lack
of trust in the system
Findings
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Develop an inventory solution utilizing both offsite warehouse
space and limited onsite space
Offsite
Identify warehouse space
Items in excess of true onsite need would move offsite
Utilize just-in-time delivery principles to get items from
warehouse to downtown as needed
Recommendations
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Develop an inventory solution utilizing both offsite warehouse
space and limited onsite space
Onsite
Organize space using 5S principles (Sort, Set in Order,
Shine, Standardize, Sustain)
Most requested items should be most accessible
Clearly labeled reorder point
Recommendations
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Determining appropriate stocking levels
Analysis of equipment transport request data, by item
Slightly skewed distributions
Performed normalization transformation
Developed a 95% tolerance interval
Calculated safety stock and reorder point*
Implementation Strategy
SS = z
α
× E(L)σ
2
D
+ (E(D))
2
σ
2
L
ROP = E(L) · E(D) + SS
* Ballou, R. H. (2011). Business logistics/supply chain management planning, organizing, and controlling the supply chain (5th ed.).
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Sample table calculations for five most requested items.
Implementation Strategy
Item
Mean
UTL
SS
Proposed
Stock
Current
Stock
Sq. ft.
per Item
Onsite Space
Need
Cot
5.3
8.7
2
11
15
2.9
31.9
Bed
2.7
5.2
1
7
28
23.7
165.9
Recliner
2.5
4.5
1
6
7
6.7
40.2
Bed
extender
1.4
2.8
1
4
4
5.3
21.2
Used
●●●
Number of Items Requested by Date - Beds
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Identified a Mayo-owned warehouse
Existing delivery schedule with four daily deliveries
Excess items moved over
Cleaned up onsite storage area
Clearly labeled reorder point
Items organized by frequency of use
Implementation Strategy
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Change management efforts in partnership with Nursing
Encourage adherence to the strategy
Returning items to the designated storage spaces
Changing behavioral norms
Ensure accountability for equipment
Pre-order for scheduled cases
Assess inventory on the floor daily
Change Management
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No reported headaches or known issues
Nearly 1200 sq. ft. of valuable real estate saved
Gained additional space for patient care
Increased compliance with Joint Commission requirements
Continuously monitoring the number of requests
We anticipate increased equipment demand with our
increasing volumes
Post-Implementation Update
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Exploring scalability at our St. Mary’s campus
24/7 Emergency Department
Much larger facility
Technical infrastructure improvements
Buy new software, or alter existing one
Automatically trigger the warehouse at the reorder point
Integration with EHR
Prompt at the creation of a transfer / discharge
Items for Further Study
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Give ample notice to all parties
Shared governance can create unexpected complications
Nursing Support Services “owns” the equipment
Environmental Services fulfills the requests
Committees allocate and designate space
Consider feasibility24 hour demand requires 24 hour supply
Lessons Learned
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Jillian S. Waller, M.H.A.
Waller.Jillian@mayo.edu
www.linkedin.com/in/jillianwaller/
Your feedback in the online session evaluation is greatly
appreciated. Thank you!
Questions